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Poor career choice 'led to suicides'

Sarah Catherall and Biddy Passmore find medicine can be over-hyped and under- funded.

Teachers are being warned not to push bright science students into medicine after fresh evidence of depression and suicide among doctors and medical undergraduates dissatisfied with their choice of career.

An Oxford University study into doctor suicides over a two-year period found a high rate of deaths among women in particular, with the reason often attributed to poor career choice.

Counsellors on the British Medical Association's helpline for stressed doctors said many trainees seeking help felt they had been pushed into medicine.

Dr Aslog Malmberg, a co-researcher on the study, told a conference on depression in health service professionals in London last week that women doctors were at three times the risk of suicide as the general population. She said seven female doctors who committed suicide between 1991 and 1993 were aged under 30 and still in training.

"High levels of dissatisfaction with career choice and an inability to see a way out of that were often the reasons," she said.

Many of the 57 doctors who took their lives during the period under study had achieved excellent results at school but were not suited to medicine because they did not enjoy contact with patients, she said.

Dr Fiona Caldicott, the president of the Royal College of Psychiatrists, told the conference that bright science students often wanted to pursue a scientific career, but were persuaded by teachers to apply for medical school.

"But teachers are not doctors," she said. "There is a lot to be done in working with schools and ensuring that the wrong people do not follow a medical career.

Dr Richard Maxwell, of the Royal College of General Practitioners, told the conference the college had been working with some schools to improve students' suitability for medicine.

"They have limited insight into what it takes to be a doctor. It has shown that they think medicine is all about what they see in Casualty," he said.

Maggie Fuller, a counsellor with the BMA's helpline, said she had advised several medical trainees who were seeking a way out of medicine.

Meanwhile, universities are threatening to refuse to admit the extra medical students the country urgently needs unless the Government provides more money to teach them, writes Biddy Passmore.

The threat was made last week by university vice-chancellors and deans of medical schools, who said recent cuts in higher education jeopardised vital research and health care and made it impossible to maintain standards in training young doctors.

Although schools came relatively well out of the last public spending round, the universities suffered a cut in income of 5 per cent, with a sharp drop of Pounds 107m (nearly one-third) in their capital spending. And, while there is a general standstill on student numbers, admissions to medical courses are meant to rise by 500 by the end of the decade to meet the demand for more UK- trained doctors in the National Health Service. Each student costs about Pounds 10,000 a year to train.

Two hundred of the extra students are either already on courses or have been promised places for this autumn. But Professor Sir Michael Thompson, vice-chancellor of Birmingham University and chairman of the vice-chancellors' medical committee, said the entry targets for 1997 were "very much in question". "We ought not to take the extra students," he told a press conference in London.

Sir Michael said the country's 22 medical schools would probably have to make some 100 staff redundant, when they needed to recruit 250. He called on the Government to restore the capital funding it removed last year and to think again about the level of funding for medical schools. This could not await the outcome of the Dearing Report on higher education.

Perhaps the most striking indication of the drop in state support came from Lord Dainton, a former chairman of the University Grants committee. In 1973, the Government had provided Pounds 2,636 a year for each medical school place, he said. That sum was now worth about Pounds 19,000, yet the average provided per place was Pounds 6,400.

Professor Stephen Tomlinson, dean of medicine at Manchester University, said that if any of his lecturers left next year he would be unable to replace them.

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